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Original Article |
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Higher frequency of early local side effects with
aqueous versus depot immunotherapy for Hymenoptera venom
allergy |
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G. Cadario1, F. Marengo1,
E. Ranghino2, R. Rossi3, B. Gatti4,
R. Cantone4, F. Bona5, R.
Pellegrino6, G. Feyles7, P.
Puccinelli8 and S. E. Burastero9 |
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1 S.C. Allergologia e Immunologia
Clinica, Azienda Ospedaliera S. Giovanni Battista di
Torino,
2 Servizio Allergologia S.C. Pneumologia - Ospedale
Civile S. Andrea - Vercelli,
3 Unità di Immunoallergologia - SSN Regione Piemonte-Savigliano
(CN),
4 U.O.N.A. di Allergologia, Ospedle Santissima Trinità,
Borgomanero (NO),
5 Pediatria, Ospedale di Rivoli (TO),
6 S.C. Medicina, Ospedale Martini Nuovo - Torino,
7 S.C. Pediatria, Ospedale Maggiore di Chieri (TO),
8 ALK-Abelḷ SpA, Lainate (MI),
9 Istituto Scientifico Ospedale San Raffaele, Milano |
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J Invest Allergol Clin Immunol
2004; Vol. 14(2): 127-133 |
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Abstract |
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Summary:
Venom immunotherapy
has proven a very
effective method for
the treatment of
allergy to
Hymenoptera venom.
Aqueous instead of
depot extracts are
prevalently used for
this immunotherapy.
The advantage of
using aqueous
extracts has not
been fully
investigated.
We made an open,
non-controlled study
on 45 subjects
sensitized to either
Apis mellifera or
Vespula spp.
Patients were
assigned to either a
depot (N=27) or an
aqueous (N=18)
immunotherapy
regimen, and side
effects were
monitored during the
induction and the 3-year
maintenance phase.
The effect of
naturally occurring
stings during the
treatment and after
its interruption was
recorded as well.
Side effects were
less frequent with
the depot extract
both on a "per
patient" (22.2%
versus 50.0%) and on
a "per dose" (2.9%
versus 10,2%) basis
(p=0.026 and
p<0.0001,
respectively).
Better tolerance was
mainly due to the
lower frequency of
local side effects
occurring at early
times after
vaccination. The
efficacy of
vaccination was
comparable in the 2
cohorts, as expected.
We conclude that
depot immunotherapy
to Hymenoptera venom
should be preferred
to aqueous
immunotherapy for
the lower occurrence
of local side
effects. This might
influence a better
compliance with this
potentially
lifesaving treatment.
Key words:
Hymenoptera venom
allergy,
immunotherapy,
aqueous extract,
depot extracts. |
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